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One-Stage Revision for Low-Grade Periprosthetic Infection with Staphylococcus hominis Following Cruciate-Retaining
Georgios Renieris1,2, Natalia Renieri1,2, Athanasios Georgokostas1,2
1Department of Orthopedic, Athens Medical Group, Psychiko Clinic, Athens, Greece.
Background:
Low-grade periprosthetic joint infections (PJIs) are diagnostically challenging and often present with subtle clinical and laboratory findings. The optimal surgical strategy - one-stage or two-stage revision - remains controversial.
Case Report:
We report a 74-year-old male with a low-grade PJI due to Staphylococcus hominis 6 months after cruciate-retaining total knee arthroplasty. Despite normal inflammatory markers, negative aspirate culture, and inconclusive imaging, tissue cultures confirmed infection. The patient underwent a one-stage revision with a favorable outcome. The immediate post-operative management was complicated by deep venous thrombosis and pulmonary embolism, prompting consideration of the risks inherent in revision surgery.
Conclusion:
One-stage revision may be a viable option for selected patients with low-grade PJI, offering comparable infection control, improved functional outcomes, and lesser complications compared with two-stage revision.
Insights
Low-grade periprosthetic joint infections (PJIs) are difficult to diagnose. One-stage revision surgery may offer good outcomes for select patients with PJI, potentially reducing complications compared to two-stage procedures.
Area of Science:
- Orthopedic surgery
- Infectious disease
- Arthroplasty
Background:
- Low-grade periprosthetic joint infections (PJIs) present diagnostic challenges due to subtle clinical and laboratory findings.
- The choice between one-stage and two-stage revision surgery for PJIs remains a subject of debate.